Psychological perspectives in urinary incontinence: a metasynthesis

Abstract

Introduction: Urinary incontinence with co-morbid depression has been found to have a significant effect on quality of life. Examining the associations between the psychosocial factors related to urinary incontinence and mental health may help in improving the care for patients with these conditions. The aim of this research study is to explore the relationship between mental health status and urinary incontinence, focusing on the role of psychosocial factors. Materials and Methods: A search of Medline, CINAHL and SCOPUS databases yielded 15 studies on the topic, and 10 studies were found to be in scope. A metasynthesis using Noblit and Hare’s approach of meta-ethnography was undertaken. This involved a number of steps including determining how studies are related and identifying major themes. Results: Three psychosocial aspects of urinary incontinence appear to influence mental health status: living with, management of and attitudes about incontinence. Other smaller component themes included control, seeking help and personal beliefs. Discussion: Psychosocial factors appear to mediate the relationship between urinary incontinence and mental health status. An increased awareness of the major psychosocial issues that can influence both incontinence and mental health may contribute to a better management of the condition as well as reduce the burden of the condition on individuals. Conclusion: Incontinence and psychological wellbeing are intertwined and this adversely affects a number of aspects of life. Enquiring about the mental health status of those with incontinence should include an assessment of psychosocial factors to help reduce the burden of incontinence. To improve the management of these conditions, further research should investigate whether psychological issues precede incontinence or vice versa.